General terms, such as industrial or occupational dermatitis or professional eczema, are used for occupational skin diseases but names related both to cause and effect are also commonly used. Cement dermatitis, chrome holes, chloracne, fibreglass itch, oil bumps and rubber rash are some examples. Because of the variety of skin changes induced by agents or conditions at work, these diseases are appropriately called occupational dermatoses.
Human skin, except for palms and soles, is quite thin and of variable thickness. It has two layers:
the epidermis (outer) and dermis (inner). Collagen and elastic components in the dermis allow it to function as a flexible barrier
Types of Occupational Skin Diseases
Occupational dermatoses vary both in their appearance (morphology) and severity.The effect of an occupational exposure may range from the slightest erythema (reddening) or discoloration of the skin.
Acute contact dermatitis (irritant or allergic).
Acute contact eczematous dermatitis can be caused by hundreds of irritant and sensitizing chemicals, plants and photoreactive agents.
Sub-acute contact dermatitis Through a cumulative effect repeated contact with both weak and moderate irritants can cause a sub-active form of contact dermatitis characterized by dry,red plaques. If the exposure continues, the dermatitis will become chronic.
Chronic eczematous contact dermatitis
When a dermatitis recurs over an extended period of time it is called chronic eczematous contact dermatitis. The hands, fingers, wrists and forearms are the sites most often affected by chronic eczematous lesions, characterized by dry, thickened and scaly skin.
Photosensitivity dermatitis (phototoxic or photoallergic)
Most photoreactions on the skin are phototoxic. Either natural and artificial light sources alone or in combination with various chemicals,
plants or drugs can induce a phototoxic or photosensitive response.
Folliculitis and acneform dermatoses, including chloracne
Workers with dirty jobs often develop lesions involving the follicular openings.
Comedones (blackheads) may be the only obvious effect of the exposure,
but often a secondary infection of the follicle may ensure.
Many types of work involve exposure to heat and where there is too much heat and sweating, followed by too little evaporation of the sweat from the skin, prickly heat can develop.
Occupationally induced changes in skin colour can be caused by dyes, heavy metals, explosives, certain chlorinated hydrocarbons, tars and sunlight.
Neoplastic lesions of occupational origin may be malignant or benign (cancerous or non-cancerous). Melanoma and non-melanocytic skin cancer.
Chromic acid, concentrated potassium dichromate, arsenic trioxide, calcium oxide, calcium nitrate and calcium carbide are documented ulcerogenic chemicals. Favourite attack sites are the fingers, hands, folds and palmar creases.
Granulomas can arise from many occupational sources if the appropriate circumstances are present.
Granulomas can be caused by occupational exposures to bacteria, fungi, viruses or parasites.